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Prophylactic Peritoneal Dialysis in Pediatric Cardiac Surgery

  • Cardiology/CT Surgery (K Gist, Section Editor)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purposeof review

This review examines the role of prophylactic peritoneal dialysis in pediatric patients after cardiac surgery. We identify benefits and risks of the intervention while highlighting gaps in current knowledge.

Recent findings

The usage of peritoneal dialysis to manage and acute kidney injury (AKI) and fluid overload (FO) after pediatric cardiac surgery may demonstrate advantages over conventional diuresis and more invasive forms of renal replacement therapies (RRT) in some patients. Outcomes vary by population in limited single and multicenter studies but suggest decreased mechanical ventilation time, earlier time to net negative fluid balance, and shorter ICU stays when compared to conventional therapies.

Summary

Prophylactic peritoneal dialysis use in the pediatric cardiac population varies widely across pediatric cardiac centers but is increasingly being demonstrated as a safe, effective treatment of AKI and FO, both of which are common and associated with deleterious outcomes in this population. Clinical decision support tools have been developed to assist in identifying patients most likely to benefit from RRT outside of the cardiac population, but further work is needed to determine if they can be applied to postoperative cardiac patients. Complications are relatively infrequent but may indicate benefits for center-specific peritoneal dialysis management protocols.

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Acknowledgements

The authors wish to thank Dr. Shina Menon for reviewing their manuscript.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Katie Brandewie & Katja M. Gist

  2. Division of Graduate Medical Education, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Katherine Melink

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Correspondence to Katja M. Gist.

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Katie Brandewie, Katherine Melink and Katja M Gist DO each declare no potential conflicts of interest.

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Brandewie, K., Melink, K. & Gist, K. Prophylactic Peritoneal Dialysis in Pediatric Cardiac Surgery. Curr Treat Options Peds 9, 136–145 (2023). https://doi.org/10.1007/s40746-023-00268-z

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